MRI pancreas scan is a method of layer-by-layer scanning of an organ by changing the polarity of protons of hydrogen atoms in the cells of the body under the influence of electromagnetic waves when the zone under study is in a constant magnetic field. It is used to visualize the structure of the parenchymal organ, ducts and vessels, as well as the adipose tissue located around the gland. It is used in the diagnosis of tumor and cystic formations of various nature, inflammatory and atrophic processes, structural anomalies. It is usually carried out with the use of a contrast agent. According to the indications, the examination is accompanied by MRI-pancreatocholangiography.
Indications
The most common indication for the appointment of an MRI of the pancreas is a suspicion of oncological organ damage. As a rule, a preliminary examination is carried out using ultrasound and CT, if the results obtained do not correspond to the clinical picture of the disease, MRI is recommended. The study is also prescribed in cases where the tumor has already been detected, but clarification of its location in the organ is required, including in relation to other structures: gland ducts, vessels, etc. These data are necessary for planning surgical treatment. In addition, MRI pancreas scan is performed in the postoperative and long-term period to assess the condition of the organ after removal of the tumor, search for metastases, etc.
An indication for examination may be chronic pancreatitis, especially its destructive form, leading to pancreatic necrosis with the formation of pseudocysts. In this case, the purpose of the procedure is not only to diagnose the inflammatory process, but also to identify its cause, since pancreatitis can be caused by a small adenocarcinoma that closes the lumen of the duct. Such formations are visualized with the greatest accuracy on the MRI of the pancreas. Also, according to the results of the examination, the stage and form of chronic pancreatitis are determined. Routine diagnostic manipulations often do not allow differentiating severe forms of pancreatic necrosis and tumors, and here MRI becomes an indispensable method of examination.
The study is used in the diagnosis of neuroendocrine tumors and insulinoma. The common bile duct is also visualized on MRI, which makes it possible to identify small concretions that are the cause of the secondary inflammatory process in the pancreas. An MRI of the pancreas may be required to establish the nature of the cystic formation. The patient’s complaints of typical shingles with irradiation in the back can become an indication for MRI if the clinical manifestations are not explained by the results of ultrasound, CT of the pancreas and other examination methods.
Contraindications
MRI is not performed if there are any metal elements and complex electronic devices in the patient’s body, the operation of which may be disrupted by a constant magnetic field. MRI of the pancreas is not recommended during pregnancy. In the first trimester, the examination is absolutely contraindicated, at a later date it is prescribed with caution. If the patient’s weight or waist exceeds the permissible values for a particular tomograph, other diagnostic methods are recommended. Despite the safety of the examination, claustrophobia can become an obstacle to MRI. This is a relative contraindication, if absolutely necessary, the scan is performed after the use of anxiolytics.
MRI pancreas scan with contrast is not prescribed for chronic renal failure and allergy to contrast agent. Also, the use of contrast is not recommended for women during lactation, according to the indications, the examination can be carried out with a subsequent break in breastfeeding for 1-2 days. Severe general somatic condition is a contraindication to MRI, as is the inability to ensure complete immobility of the patient during the scan. The need for the procedure in such cases is determined individually, it is possible to use anesthesia.
Preparation
Within 1-2 days before the MRI pancreas scan, it is necessary to follow a diet with the exception of black bread, legumes, dairy and other products that cause increased gas formation. The study is performed on an empty stomach, 2 hours before the procedure, the patient takes activated charcoal. Antispasmodics are recommended about an hour before the start of the scan.
Methodology of conducting
The subject is located on a pull-out table, which is placed in the center of the tomograph for the duration of the scan. The recommended position is lying on your back, bolsters are placed under your head and legs for convenience. Some pictures are taken at the moment of holding your breath, as the doctor informs you in advance. The system for intravenous contrast is installed before the procedure begins. During the administration of the contrast agent, the patient may feel warmth and heat in the body, dizziness, which pass within a few minutes. The total duration of an MRI pancreas scan is about 30 minutes. Taking into account the preparation time, including medication, the duration of the study increases.
Complications may be associated with the contrast agent used if the subject has a burdened allergic history or chronic renal failure. The danger to the patient is represented by metal elements that have not been identified in advance. For this reason, it is necessary to inform the doctor about all metals in the body, even if they are bullet fragments or structures whose composition is unknown to the patient. The result of an MRI pancreas scan is prepared within a few hours. The patient receives pictures and a conclusion, if desired, the results are recorded on a digital medium or sent by e-mail.
